Androgenetic (or pattern) alopecia is a genetically determined disorder characterized by the gradual conversion of terminal hairs into indeterminate, and finally into vellus, hairs. It is an extremely common disease that affects men and women.
Signs and symptoms
Signs of androgenetic alopecia include the following:
Diffuse alopecia areata may mimic the androgenetic form. The presence of exclamation point hairs, pitted nails, or a history of periodic regrowth or tapered fractures noted on hair counts suggests the diagnosis of diffuse alopecia areata.
See Clinical Presentation for more detail.
History and the physical examination are the most important aspects of diagnosis in patients with androgenetic alopecia. The following laboratory tests, however, can play a role in patient assessment:
Biopsy and Histology
A biopsy is rarely necessary to make the diagnosis of androgenetic alopecia. If a single biopsy specimen is obtained, it should generally be sectioned transversely if pattern alopecia is suspected.
In androgenetic alopecia, hairs are miniaturized. Although the condition is considered a noninflammatory form of hair loss, a superficial, perifollicular, inflammatory infiltrate is noted at times. A mildly increased telogen-to-anagen ratio is often observed.
See Workup for more detail.
The following drugs have been approved by the FDA for the treatment of androgenetic alopecia:
The cosmetic results of surgical treatment for androgenetic alopecia are often satisfactory.
Micrografting produces a more natural appearance than does the old technique of transplanting plugs.